Today is International Women's Day. But with the right accelerating its attacks on choice, women – and men – have little to celebrate. The stakes for families around the world are high, and the impact is already being felt.
In its relentless drive to undermine family planning, the Bush administration may well see its policies increase abortion at home and exacerbate poverty abroad.
To the detriment of all, and particularly poor women, hard-line abortion opponents in the White House, Congress, and state legislatures view not only abortion but even contraception as an evil. Ideology trumps facts that demonstrate that family planning is the only realistic and proven means of reducing abortion rates and empowering women, and men, to make decisions about their lives and their families.
Many abortion opponents attack safe and reliable family planning methods such as birth control pills, and even condoms. This view is apparently shared by President Bush and anti-choice legislators whose policies and regulations are making contraception less available domestically and in countries around the world.
Since taking office, the Bush administration has tried unsuccessfully to reverse a 1998 law that ensures contraceptive coverage for the 3.8 million women covered by the Federal Employee Health Benefits Plan. Similarly, the administration opposes legislation that would ensure that insurance companies provide coverage for prescription contraceptives in the same manner as all other prescription drugs and devices.
The administration also has the Title X family planning program in its cross-hairs. Signed into law by President Richard Nixon and supported by former President George Bush when he was in Congress, Title X provides services to low-income men and women. In addition to contraception, Title X-funded clinics provide basic health services, including pap smears and breast cancer screenings, to almost 5 million women. Because of the Title X program, hundreds of thousands of pregnancies, including many that would have ended in abortion, are avoided. But, instead of increasing support for this tried and true program, the Bush administration is increasing federal dollars for unproven, abstinence-only programs.
And the White House is on a similar tack abroad. Less than 48 hours after he was sworn in, President Bush reinstated the "Mexico City Policy" which denies funds from the U.S. Agency for International Development to overseas clinics that use funds from any source to perform abortions, provide abortion counseling and referral, or lobby to make abortion legal. Last August, Bush expanded the policy to apply also to State Department programs.
What is known as the "global gag rule" is having a devastating impact on women and families in the developing world. Without U.S. assistance, health clinics have closed in Nepal, Zambia, Ethiopia, Kenya and Uganda. The loss of USAID funding has forced others around the world to cut staff and services, including for HIV screening, voluntary counseling and education. At a time when the spread of HIV-AIDS has dramatically elevated the demand for condoms, USAID has stopped shipment of condoms to 16 countries because the sole recipients – local family planning organizations – have refused to sign on to the gag rule. Meanwhile, USAID has even gone so far as to reduce the availability of information about condom use, removing from its website a report on "The Effectiveness of Condoms in Preventing Sexually Transmitted Infections" and rewriting fact sheets to de-emphasize the importance of condom use in HIV prevention. The administration's reach has extended to multilateral forums, where official U.S. delegations have attempted to overturn international agreements on the right of young people to information about sexual abuse, birth control and condoms, and opposed the promotion of condoms to prevent the spread of HIV.
Back at home, meanwhile, some states are positioning themselves to follow the federal lead. A recent report by the Planned Parenthood Federation of America cites efforts in Kentucky to withdraw from the Title X program, and in North Carolina to weaken the state contraceptive equity statute. In both cases, officials erroneously equate contraception with abortion. In 2003, other state governments – Michigan, Minnesota, Missouri, Nebraska, New Jersey, New York, North Carolina, Ohio, Pennsylvania, Rhode Island, West Virginia, and Wisconsin – considered or enacted legislation that would deny or reduce funds to publicly-funded family planning providers because they offer abortion counseling, or provide or refer for abortion services.
While the Bush administration and its allies make the decisions governing how women and men plan their families, millions of women in the United States and around the world – and particularly the poorest among them – pay the price.
American women spend most of their child-bearing years trying to avoid becoming pregnant – without contraception, a woman would have between 12 and 15 pregnancies in her lifetime. As a result, when insurers don't cover prescription contraceptives, women incur additional health care costs and may choose to use less reliable, less expensive forms of contraception. Attacks on the Title X family planning program may discourage low-income women from using contraception at all. The obvious result for all women is unintended pregnancy – 48 percent of pregnancies among American women are unintended, and half of those are terminated by abortion. If the administration's policies are pursued unchecked, this sad reality will worsen.
And in the developing world, more health centers will close, more services will be curtailed, and more women will be forced to forego meaningful reproductive health care altogether. As condoms become less available, unprotected sex will yield more, rather than fewer, HIV infections. And as information on birth control and condoms grows less available, young people will make ill-informed and unhealthy choices.
President Bush and his allies have upped the ante in the battle over abortion, and turned it into a full-scale war on family planning. But as this war unfolds, women and men of good conscience need to understand that what is at stake here is the future of literally millions of women, their families, communities and societies.
Family planning is about providing people with the power to make rational decisions. For women, it provides the power to decide if, when and how many children they will bear, and to strike a responsible balance between their roles as providers and producers. For men and women, it provides the power to make sound decisions about producing and caring for healthy families, as well as protecting against disease and even death. Moving swiftly and comprehensively, the Bush administration and its allies are working to ensure that these powers rest not with individuals, but with an ideological elite bent on making decisions on their behalf.
Melody Barnes and Gayle Smith are senior fellows at the Center for American Progress.
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